The goal of any good fall reduction program will incorporate a proactive approach to assessing patients while determining the risk for falls. It will also create a culture of urgency around preventing falls, particularly in the individuals who are at greater risk of serious injury.
Falls are the leading cause of injury-related deaths among persons aged 65 and older. The rate of deaths from falls among persons 65 and older has increased 31% in the years 2007 to 2016. Approximately 30,000 adults aged 65 and older died as a result of a fall in 2016. As this age population continues to grow, we should be able to implement strategies to address the increased fall rate. This can be addressed by screening for fall risk and intervening to address any modifiable risk factors such as duplicate medications, gait, strength, and balance issues. All of this will be explored and outlined in a comprehensive Fall Risk Reduction Plan called Be-Steady.
Let’s look at some sobering statistics. More than one out of four older people fall each year, but less than half report this to their healthcare provider. One fall doubles the chance of falling again. Falling is a billion-dollar business. In 2015, the total medical costs for falls reached more than $50 billion.
Approximately half of the 1.6 million nursing home residents in the United States fall each year, and a 2014 report by OIG found that almost 10% of Medicare skilled nursing facility residents experienced a fall resulting in significant injury. Falls are responsible for almost 600,00 hospitalizations or transfers to special care each year. Only 50% of those with a serious fall will be alive one year later. Many people who fall, even if they are not injured, will become afraid of falling. This fear may start a dangerous cascade and cause a person to cut down on their everyday activities. When a person is less active, they become weaker, and in turn, may increase the likelihood of a fall creating a vicious cycle.
Certain diagnoses, medications, and conditions will increase the likelihood of an injury if a person falls. These key risk factors which increase the chance of significant injury include history of falls, patients needing assistance with ambulation or use of assist device, a diagnosis of osteoporosis, and certain medications. Consider the individual who routinely takes a prescribed anticoagulant for a known medical diagnosis. Those patients require thorough assessment if they have a fall, late onset injuries are known to occur up to 72 hours after a fall in persons taking anticoagulants. A complete falls risk assessment is imperative to identify those patients at higher risk for injury and should also include review of cognitive status, as well as routine lab values. This should be a comprehensive review.
Falls reduction strategies are not a one-time assessment, it is an ongoing process. As patient status changes or medication changes occur, a falls risk reassessment is necessary. This will help ensure that all factors are considered when creating an individualized fall safe plan for each patient.
A good falls reduction program will include all team members, will require interdisciplinary participation, and education to patient and family. Join us as we launch Be-Steady and don’t fall behind on patient safety initiatives.
CDC Morbidity and Mortality Weekly Report 5/11/18
LTC Blog: Long Term Care Statistic You Need to Know in 2018 10/3/18
AHRQ Patient Safety Network September 2019